Identifying Triggers for Eating Disorders

by Phyllis Spahn, LPC, NCC, LDN

Every year a week in February is designated as National Eating Disorders Awareness Week by The National Eating Disorders Association (NEDA).  The theme for 2014 was “I Had No Idea” stressing the need to address misconceptions about eating disorders.  Additionally, March is the month when recognition is directed at the importance of nutrition for everyone.  The American Academy of Nutrition and Dietetics chose “Enjoy the Taste of Eating Right” as the message for National Nutrition Month 2014.  As a Registered Dietitian/Nutritionist and a Licensed Professional Counselor, I have reflected on what these national designations with focus on nutrition and eating disorders mean to my clients.  

I am sure you have heard the statement, “You are what you eat”.  I wonder though, am I really what I eat?  If so, I hope all that I consumed during the past week while skiing in the beautiful Rocky Mountains doesn’t contribute to my health in a significant way!  The choices available in the mountainside chalets are more plentiful than one might guess.  However, the less nutritious choices such as cheese paninis, creamy soups, and french fries won out fairly often. In addition, eight of the ten family members, along with many other travelers, were visited by the wickedly aggressive Norovirus, which after its 24 hours of vengeance, forced us to limit our diet to bland low-fiber foods for several days.

Now in the big picture, a week such as that will not nutritionally make or break an individual.  All is well as long as we subscribe to the idea of moderation that Registered Dietitian-Nutritionists have promoted for years.  Many foods that we would not advise consuming in excess are acceptable when consumed infrequently or in moderation at best. Most of us understand and practice this advice when it comes to vacations, holidays, and other special events.  In return, we rely on the scale, the way our clothes fit, how we feel, and on our healthcare providers to monitor our health status.  We make adjustments accordingly to achieve optimal health and well-being.

However, this is where the problem enters in for individuals who are on the spectrum of eating disorders.  The pleasure of food is lost in their world of black-and-white and all-or-none styles of thinking.  Enjoyment of food during family dinners, celebrations, or any type of get-together succumbs to fear of being fat or being less than lovable.  One’s ability to see the bigger picture is diminished to non-existence, thereby removing the ability to “enjoy the taste of eating right”.  The reality for those struggling is constant anxiety and fear directed toward mealtimes.

Eating disorders are very complex in nature with multifaceted causes.  They are a serious illness and not a lifestyle choice, contrary to common misconceptions. They are not restricted to race, gender, ethnicity, or socioeconomic systems.  They occur on a spectrum in different forms that include anorexia (restricting), bulimia (purging through vomiting, laxatives, and excessive exercise), binge eating, and pregorexia (occurring during pregnancy).  According to NEDA, in the United States, 20 million females and 10 million males will suffer from a clinically significant eating disorder in their life time.  Many more of all ages will experience disordered eating even if not diagnosed as an eating disorder.  Anorexia Nervosa has the highest mortality rate of any mental illness. Females with anorexia nervosa are twelve times more likely to die from the illness than all other causes of death.

Eating disorders are the result of an extensive list of possible triggers. A few examples include adolescents and young adults who have:

• lost excess body weight by semi-starvation and upon arriving at their recommended weight are unable to discontinue the weight loss process. It is a wise parent who seeks help for their teen or young adult for therapy because they recognize the destructive pattern their child has been on to obtain the weight loss.
• developed an eating disorder as a result of trauma, abuse, bullying by peers, or ongoing familial dysfunction.  Eating disorders can result because an adolescent feels unlovable or unaccepted by peers or family.  For example, a daughter who is paid money for pounds lost by her father, or whose mother will buy her a certain prom dress only when her daughter loses weight to a predetermined dress size, receives a powerful message that she isn’t good enough or that the parent’s love may be conditional.  If the unobtainable trait of perfectionism is a family value, an eating disorder can develop which in turn forces the family focus to change.
• based their feelings about themselves on cultural messages bombarding them with airbrushed, photo enhanced images of perfection or skinny, even emaciated looking bodies, being presented as the ideal.  A vicious cycle of restricting and self-loathing develops as the individual struggles to “measure up”.

Remember, even in present day busy lifestyles that include vacations and illness, it remains important to strive for balance in nutrition and for maximum physical and emotional health.

If you have concerns that you or a loved one may be struggling with issues related to eating or weight, it is imperative that you seek advice from a healthcare provider. Early intervention leads to a higher likelihood of recovery.

Additionally, an excellent resource is www.nationaleatingdisorders.org. There you will find online screening tools, an extensive tool kit for parents, coaches, and educators, a helpline, and referrals for treatment.